| Date of birth: | May 31, 1963 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00017419 |
| Booking date: | Nov 5, 2003 |
| Release date: | Nov 12, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | DEL.9999.999 - CIVIL COMMIT CHILD SUP. |
| Offense date: | Nov 5, 2003 |
| Case number: | 94-1409FDKB |